Histoplasmosis in eastern India: the tip of the iceberg?

Goswami, Ravinder; Pramanik, Netai; Banerjee, Dibyesh; Raza, Murtajiz M; Guha, Suparna; Maiti, Prabal K.

doi:10.1016/s0035-9203(99)90374-7

Cited by 47 publications

(46 citation statements)

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“…Several studies have shown the occurrence of hepatomegaly and/or high levels of AST and alanine aminotransferase in patients with histoplasmosis. 12,[14][15][16][17] Respiratory insufficiency is known to be a classic risk factor for death in patients with disseminated histoplasmosis, and this was confirmed in our study. Univariate analysis showed that serum creatinine levels > 1.5 mg/dL on hospital admission were associated with death.…”

supporting

confidence: 80%

Risk Factors for Death in Acquired Immunodeficiency Syndrome–associated Disseminated Histoplasmosis

Daher¹,

Barros²,

Silva³

et al. 2006

The American Journal of Tropical Medicine and Hygiene

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Abstract. We performed a retrospective study of 164 human immunodeficiency virus (HIV)-infected patients with disseminated histoplasmosis to identify the risk factors for death. Death occurred in 32% of the cases. Univariate analysis identified the following risk factors: diarrhea (odds ratio [OR] ‫ס‬ 3.9, P ‫ס‬ 0.001), neurologic manifestations (OR ‫ס‬ 5.8, ; P ‫ס‬ 0.001), hemoglobin level < 8.0g/dL (OR ‫ס‬ 2.7, P ‫ס‬ 0.004), urea level 2 times the normal upper limit (OR ‫ס‬ 5.0, P < 0.001), creatinine level > 1.5 mg/dL (OR ‫ס‬ 2.9, P ‫ס‬ 0.005), aspartate aminotransferase (AST) level > 2.5 times the normal upper limit (OR ‫ס‬ 3.1, P ‫ס‬ 0.01), respiratory insufficiency (OR ‫ס‬ 9.7, P < 0.001), sepsis (OR ‫ס‬ 20.2, P < 0.001), and acute renal failure (OR ‫ס‬ 2.5, P ‫ס‬ 0.011). A hemoglobin level < 8.0 g/dL (OR ‫ס‬ 3.8, P ‫ס‬ 0.008), an AST level Ն 2.5 times the normal limit (OR ‫ס‬ 1.0, P ‫ס‬ 0.007), acute renal failure (OR ‫ס‬ 2.96, P ‫ס‬ 0.015), and respiratory insufficiency (OR ‫ס‬ 12.2, P ‫ס‬ 0.01) were independent risk factors for death.

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supporting

confidence: 80%

Risk Factors for Death in Acquired Immunodeficiency Syndrome–associated Disseminated Histoplasmosis

Daher¹,

Barros²,

Silva³

et al. 2006

The American Journal of Tropical Medicine and Hygiene

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“…Although India being a nonendemic area for histoplasmosis, there have been few reports in the recent past, mainly from the eastern parts of the country. 12 The spores of H. capsulatum is commonly found in soils contaminated with bird droppings. The fungal spores were isolated from Gangetic delta soil.…”

Section: Discussionmentioning

confidence: 99%

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Singh¹

2017

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Background:There have been sporadic reports of histoplasmosis from India. Although traditionally considered a disease of immunocompromised hosts, immunocompetent patients presenting with adrenal histoplasmosis have been reported. Endoscopic ultrasound (EUS) provides easy and safe approach to adrenal glands for fine needle aspiration. Methods: We report 10 cases of adrenal histoplasmosis diagnosed by endoscopic ultrasound (EUS) guided FNA. The mean age at diagnosis was 54 ± 9 years, all were males. Eight patients were immunocompetent while two had cirrhosis; none of them was retrovirus positive. All patients presented with fever and weight loss, 8 had bilateral adrenal enlargement while 2 had isolated left adrenal enlargement. EUS features included hypoechoic (30%) or heteroechoic (70%) adrenal glands, presence of hypoechoic areas suggestive of necrosis within the gland was identified in 40% of these patients. Adrenal insufficiency was present in 1 patient (10%) which persisted even after successful treatment. Conclusion: Adrenal histoplasmosis should be considered even in immunocompetent hosts presenting with constitutional symptoms and adrenal enlargement. EUS guided FNA is a safe and accurate modality for adrenal sampling.

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“…The persistence of these organisms is dependent on the iron and calcium concentration in the phagosomes. 1 From the alveoli, the yeasts are transported by the phagosomes to the local draining lymph nodes...and from there hematogenous spread of these yeast infected phagosomes distribute them to the various organs of the body...resulting in disseminated histoplasmosis. Progressive disseminated histoplasmosis (PDH) can involve multiple organs, most commonly the bone marrow, spleen, liver, adrenal glands, and mucocutaneous membranes.…”

Section: Discussionmentioning

confidence: 99%

Progressive disseminated histoplasmosis presenting like chronic parenchymal liver disease with ascites: a rare case report and discussion

Banerjee

2014

Int J Res Med Sci

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Histoplasmosis in eastern India: the tip of the iceberg?

Cited by 47 publications

References 1 publication

Risk Factors for Death in Acquired Immunodeficiency Syndrome–associated Disseminated Histoplasmosis

Risk Factors for Death in Acquired Immunodeficiency Syndrome–associated Disseminated Histoplasmosis

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Progressive disseminated histoplasmosis presenting like chronic parenchymal liver disease with ascites: a rare case report and discussion

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